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The use of sirolimus-based immunosuppression protocols have been reported to reduce recurrence rates following liver transplantation for hepatocellular carcinoma, although this is still a matter for debate. Dr Menon and colleagues from the United Kingdom performed a systematic review and meta-analysis of available literature on the usage of sirolimus as an immunosuppressive agent following liver transplantation for hepatocellular carcinoma, with a view to comparing cancer outcomes with the commonly used calcineurin inhibitors The team's primary outcomes of interest were tumor recurrence rate and recurrence-free survival. Secondary outcomes were recurrence-related mortality, and overall survival. The researchers noted that in all, 5 studies met the inclusion criteria.  | | The 1-year recurrence-free survival was 93% to 96% | | Alimentary Pharmacology & Therapeutics |
The recurrence rate was lower in sirolimus group in comparison with calcineurin inhibitors. The doctors found that the 1-, 3- and 5-year recurrence-free survival was 93% to 96%, 82% to 86%, and 79% to 80% for sirolimus group, which was much better in comparison with the calcineurin inhibitors at 70%-78%, 64% to 65%, and 54% to 60%, respectively. Similarly, 1-, 3- and 5-year overall survival was much better for sirolimus group in comparison with calcineurin inhibitors respectively. The team of reseacrchers demonstrated that lower recurrence, lower recurrence-related mortality and lower overall mortality for sirolimus group. Dr Menon's team concludes, "The review showed lower recurrence rate, longer recurrence-free survival and overall survival and lower recurrence-related mortality in sirolimus-treated patients in comparison with the calcineurin inhibitor-treated patients following liver transplantation for hepatocellular carcinoma."
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